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[Selection strategy for graft source in 2023].

Seitaro Terakura
Published in: [Rinsho ketsueki] The Japanese journal of clinical hematology (2023)
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) grafts have expanded from related human leukocyte antigens (HLA)-matched donors to unrelated HLA-matched donors and umbilical cord blood. Either one of these grafts is now available for almost all patients who need allo-HSCT. Furthermore, an allo-HSCT from an HLA one haplo-mismatched donor can be safely performed with cyclophosphamide administration after transplantation. Graft-versus-host disease (GVHD) and graft-versus-leukemia effects are inextricably linked in allo-HSCT, and a transplant with more GVHD-associated complications is not necessarily a worse transplant as a graft selection indicator. Transplants with severe GVHD have fewer relapses, which offset the negative effects. This study presents data to guide graft selection by comparing transplant outcomes from different donor sources. The current position of post-transplant cyclophosphamide haplo from HLA-one haplo mismatched donor is also discussed based on data presented to date.
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